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Biomedical subjects

A Hashimoto

Publications and source records attributed to A Hashimoto.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Long-term results of porcine bioprosthetic heterograft; a 13-years' experience].

One hundred and ninety-four patients underwent valve replacements with the glutaraldehyde-preserved porcine bioprostheses (133 Hancock valves, 39 Angell-Shiley valves, 22 Carpentier-Edwards valves and 3 other valves) from 1974 through 1979. There were 105 women and 89 men, whose age ranged 18 to 62 (mean 38.8) years. One hundred and eighty-two patients had mitral bioprosthetic valve replacement (BVR)s, of which 52 had combined aortic mechanical valve replacements, 8 had aortic BVR's, 3 had tricuspid BVR's and 3 had multi-BVR's. Operative mortality was 10.8%. Only one patient was lost to follow-up. Cumulative duration of follow-up is 1421 patient-years. Linearized rate of anticoagulant related hemorrhage, thromboembolism (TE), prosthetic valve endocarditis (PVE), primary tissue failure (PTF) and valve dysfunction (VD) were 0.07, 1.62, 0.49, 2.74 and 3.66% per patient-year. Actuarial freedom from TE, PVE, PTF and VD were 87.0 +/- 2.7%, 95.6 +/- 1.5%, 65.2 +/- 4.9% and 56.9 +/- 5.6% at 13 years. Actuarial survival rate was 67.4 +/- 4.0% at 13 years. Long term follow-up after valve replacement with porcine bioprosthetic valve confirms low thrombogenicity. But primary tissue failure was the chief cause of valve dysfunction and represent a major problem. At this time, we are going to use porcine bioprosthetic valve in the selected patients, that is in the situations in which anticoagulation is contraindicated.

Adolescent↗
PubMed1988

[Limitations and extension of surgical indications for acquired valvular heart disease; retrospective study of hospital death].

Between 1981 and 1987, valvular surgery was performed in 988 patients, 27 of which were dead before discharge. Among them, 14 patients of cardiac deaths due to low cardiac output syndrome (LOS) and arrhythmias were analyzed to withdraw factors correlated with their cause of death. There was a tendency for the patients with stenotic valvular disease to die of LOS and regurgitant valvular lesions of arrhythmias. Statistical analysis showed the cause of deaths were multifarious including pulmonary, hepatic and renal failure, so no definite factor was pointed out. Case study of typical limited and extended surgical indications revealed (1) the patients with mitral stenosis combined with organic tricuspid regurgitation and RV/LV EDVI ratio over 1.5, and (2) the patients with aortic insufficiency and LVEDVI over 400 ml/m2 or LVESVI over 300 ml/m2 were candidate for hospital death after valve replacement. Extended approach for those patients should be two staged heart transplantation using ventricular assist device.

Adult↗
PubMed1988

[Clinical study of "stent creep" in porcine bioprosthesis].

Stent creep is often associated with malfunction of bioprosthesis. We measured the inward bending angle of the stent-post showing maximum bending (IBA) on 42 mitral porcine xenografts retrieved 1 to 12 yrs (mean 7.7 yrs) postoperatively at reoperation. Patients were 12 men and 28 women, ranging in age from 26 to 58 yrs. Mean +/- S.D. for IBA was 12.7 +/- 4.2 degrees(ds) in 14 valves being implanted for less than 7 yrs and 16.9 +/- 5.5 ds in 28 valves longer than 8 yrs (p less than 0.05). There was a significant difference in IBA between 36 valves of 25-29 mm size (16.3 +/- 5.1 ds) and 6 valves of 31 mm (10.3 +/- 5.5 ds) (p less than 0.05), but no significant difference between 23 Hancock valves (15.5 +/- 4.4 ds), 10 Angell-Shiley valves (16.2 +/- 8.6 ds) and 9 Carpentier-Edwards valves (14.4 +/- 3.7 ds). IBA showed a tendency to have large valve in the heart with small left ventricular end-systolic volume. The results showed that stent creeping phenomenon was not related to the material or design of stent-post, but tended to increase with passage of time in place. Furthermore, it was suggested that stent creep was induced by the mechanism of compression of the stent by the left ventricular wall.

Adult↗
PubMed1987

Efferent connections of the rostral portion of medial agranular cortex in rats.

This study of the rostral part of medial agranular cortex (AGm) was undertaken with two principal aims in mind. First, to delineate the efferent connections of AGm and compare these with the pattern of afferents defined by us in a previous study. Second, to provide a firmer basis for anatomical and functional comparisons with cortical regions in monkeys. Autoradiographic, horseradish peroxidase, and fiber degeneration techniques were used. Rostral AGm has a variety of corticocortical connections--with lateral agranular motor cortex (AGl); visual, auditory, and somatic sensory regions; and limbic/paralimbic areas including orbital, insular, perirhinal, entorhinal, retrosplenial and presubicular fields. The projections to orbital, perirhinal and entorhinal cortices are bilateral. Thalamic projections of rostral AGm are concentrated in the ventral lateral, central lateral, paracentral, mediodorsal and ventromedial nuclei. Moderate terminal fields are consistently seen in the reticular, anteromedial, central medial, gelatinosus, parafascicular, and posterior nuclei. More caudal projections reach the central gray, superior colliculus and pontine gray. The efferents of the adjacent AGl were also examined. Although many of these overlapped those of rostral AGm, there were no efferents to visual or auditory cortex and limbic/paralimbic projections were reduced. Thalamic projections were more focused in the ventral lateral and posterior nuclei and there were no terminal fields in the central gray or superior colliculus. Based on its afferent and efferent connections, role in contralateral neglect, and the results of microstimulation studies, rostral AGm can be viewed as a multimodal association area with strong ties to the motor system. On these structural and functional grounds, rostral AGm bears certain striking resemblances to the frontal eye field, supplementary motor, and arcuate premotor areas of monkey cortex.

Animals↗
PubMed1987

Six-year experience with the St. Jude Medical prosthesis: early and late results of 540 valves in 462 patients.

From July 1978 to June 1984, 540 St. Jude Medical valve prostheses were implanted in 462 adult patients. Overall operative mortality was 4.8% (22/462): 5.7% after aortic valve replacement (AVR) (8/140); 3.3% after mitral valve replacement (MVR) (8/244); and 7.7% after aortic and mitral valve replacement (DVR) (6/78). There were 16 late deaths among 440 operative survivors; six (38%) were valve related. The actuarial survival rate at six years was 94.5% in AVR and 93.5% in MVR. At five years it was 91.6% in DVR. The freedom from valve-related death at six years after AVR, MVR and at five years after DVR was 97.8%, 98.6% and 95.8%, respectively. The incidence of valve-related complications (expressed as %/patient-year (number of events] was as follows: thrombo-embolism (AVR 0.7 (2), MVR 2.0 (13), DVR 2.8 (5], valve thrombosis (AVR 0.3 (1), MVR 0.2 (1), DVR 0 (0], prosthetic valve endocarditis (AVR 0.3 (1), MVR or DVR 0 (0]. There were no cases of primary structural failure, serious anticoagulant-related hemorrhage or clinical event of hemolysis. The incidence of all valve-related complications in AVR, MVR and DVR was 1.3, 2.2 and 2.8%/pt-yr, respectively. The freedom from thrombo-embolism at six years after AVR and MVR and at five years after DVR were 91.4%, 92.4% and 88.7%, respectively. Re-operation was performed in only one patient with MVR because of valve thrombosis (0.2%/pt-yr after MVR, overall 0.1%/pt-yr). These results indicate that St. Jude Medical prosthesis has provided a satisfactory performance with acceptable risks of late complications in patients who were properly anticoagulated during six-year follow-up period.

Adolescent↗
PubMed1987

Intraatrial conduit repair in Scimitar syndrome.

A 26-year-old woman with partial anomalous pulmonary venous drainage into the right atrium (Scimitar syndrome) was successfully operated upon by incorporating an intra-atrial conduit. The single right pulmonary vein present was connected to the right atrial inferior vena cava junction. The atrial septum was extremely deviated to the left, and the left atrium was located entirely on the left of the spine. A small patent foramen ovale was found. The distance between the orifice of the right pulmonary vein and the enlarged atrial septal defect was too great to use an intracardiac patch, so a 14 mm woven Dacron graft, 6 cm long, was interposed between them. The patient is doing well 21 months following the operation.

Adult↗
PubMed1987

Angiotensin converting enzyme in sarcoidosis and in silicosis.

Angiotensin converting enzyme (ACE) activities of bronchoalveolar lavage fluid (BALF) and serum in patients with sarcoidosis and with silicosis were measured. Serum ACE was measured by enzymic assay and radioimmunoassay. There was a close relationship between ACE activity and content (r = 0.78). Serum ACE activities in patients with active sarcoidosis (37.5 +/- 11.1 nmol/min/ml, mean +/- SD) and with silicosis (25.5 +/- 9.3) were significantly elevated from the control (18.6 +/- 6.0). BALF ACE activities in the control, patients with active sarcoidosis and with silicosis were 0.23 +/- 0.19 nmol/min/ml, 0.94 +/- 0.97 and 0.38 +/- 0.05, respectively. BALF ACE in patients with active sarcoidosis and with silicosis were significantly different from the control. When BALF ACE was corrected by the cell count of alveolar macrophage (per 10(6) cells), activity was significantly different from control only in the patients with sarcoidosis. Moreover, only the alveolar macrophages in sarcoidosis were stained by immunofluorescence and immunocytochemistry using rabbit antihuman ACE antibody. Induction of ACE in alveolar macrophage might have an important role for the activity or progression of sarcoidosis.

Adult↗